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Eur Radiol. 2017 Mar;27(3):956-965. doi: 10.1007/s00330-016-4440-1. Epub 2016 Jun 2.

Prediction of the treatment outcome using intravoxel incoherent motion and diffusional kurtosis imaging in nasal or sinonasal squamous cell carcinoma patients.

Author information

1
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N15, W7, Kita-Ku, Sapporo, 060-8638, Hokkaido, Japan. Noriyuki.Fujima@mb9.seikyou.ne.jp.
2
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N15, W7, Kita-Ku, Sapporo, 060-8638, Hokkaido, Japan.
3
Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
4
Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
5
The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Sapporo, Japan.

Abstract

OBJECTIVES:

To evaluate the diagnostic value of intravoxel incoherent motion (IVIM) and diffusional kurtosis imaging (DKI) parameters in nasal or sinonasal squamous cell carcinoma (SCC) patients to determine local control/failure.

METHODS:

Twenty-eight patients were evaluated. MR acquisition used single-shot spin-echo EPI with 12 b-values. Quantitative parameters (mean value, 25th, 50th and 75th percentiles) of IVIM (perfusion fraction f, pseudo-diffusion coefficient D*, and true-diffusion coefficient D), DKI (kurtosis value K, kurtosis corrected diffusion coefficient Dk) and apparent diffusion coefficient (ADC) were calculated. Parameter values at both the pretreatment and early-treatment period, and the percentage change between these two periods were obtained.

RESULTS:

Multivariate logistic regression analysis: the percentage changes of D (mean, 25th, 50th, 75th), K (mean, 50th, 75th), Dk (mean, 25th, 50th), and ADC (mean, 25th, 50th) were predictors of local control. ROC curve analysis: the parameter with the highest accuracy = the percentage change of D value with the histogram 25th percentile (0.93 diagnostic accuracy). Multivariate Cox regression analyses: the percentage changes of D (mean, 25th, 50th), K (mean, 50th, 75th), Dk (mean, 25th, 50th) and ADC (mean, 25th, 50th) are predictors.

CONCLUSIONS:

IVIM and DKI parameters, especially the D-value's histogram 25th percentile, are useful for predicting local control.

KEY POINTS:

• Noninvasive assessment of treatment outcome in SCC patients was achieved using IVIM/DKI. • Several IVIM and DKI parameters can predict the local control. • Especially, the D-value's histogram 25th percentile has high diagnostic accuracy.

KEYWORDS:

Diffusion magnetic resonance imaging; Magnetic resonance imaging; Prognosis; Squamous cell carcinoma of the head and neck; Treatment outcome

PMID:
27255401
DOI:
10.1007/s00330-016-4440-1
[Indexed for MEDLINE]

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